Groundbreaking Retina Research Preserves Sight

By Beth Miller

Photography by Daniel Smyth

Our eyes are intricate tools that gather light and communicate with the brain, creating conversations through its many working parts. Loss of sight is a dreaded disability, and one the Cincinnati Eye Institute (CEI) is actively fighting.

The retina is a layer of cells in the innermost part of three basic tissues that make up the eye: the sclera, encasing the eyeball in a white color; the choroid, the eye’s blood supply; and the retina is the light sensor for the eye.

CEI is a national leader in the area of retina research, conducting cutting edge surgeries, therapies and clinical trials to bring clarity to patients’ retinal problems.

Daniel M. Miller, MD, PhD, is medical director of CEI and specializes in all medical and surgical retinal diseases. He also has led more than 30 clinical trials. Dr. Miller was recently awarded the top surgery from the fourth annual Vit-Buckle Society, an international retinal surgery conference. This was no routine surgical procedure; the surgery was live streamed to the Vit-Buckle Society meeting with attendees from around the world. Other participating surgeons were from Cleveland, San Francisco and San Juan, Puerto Rico. “Conference participants could look through my microscope feed and a panel asked questions about my techniques while I operated,” says Dr. Miller. “It was a retinal detachment surgery in a diabetic patient with diabetic retinopathy – many complex maneuvers were used.”

Dr. Miller decided to become an ophthalmologist in medical school after observing a surgeon performing retinal surgery on a diabetic patient – similar to the Vit-Buckle Society procedure.

As the aging population continues to increase, the number of patients living into their 80s and 90s is expanding, along with eye problems that occur in the elderly: macular degeneration, a disease that gradually destroys central vision; diabetic retinopathy, occurring as diabetes damages blood vessels inside the retina; retinal detachment, when the retina is pulled away from its position at the back of the eye.

“One of the biggest challenges are the unmet needs; there currently is no treatment or cure for dry macular degeneration – patients slowly lose their vision throughout 10 to 15 years,” says Dr. Miller. “Fortunately CEI is one of the leading centers in the U.S. in terms of having multiple trials and investigating new therapies and some show promise.”

The talented team of retina doctors at CEI are involved in multiple lines of research to generate the next generation of treatments and surgeries for these diseases.

CEI currently has five active clinical trials; one involves injecting cells underneath the retina to try and recover vision in patients who have gone blind from macular degeneration. Another study includes implanting a device that can release medications into the eye over a period of time, allowing patients the relief of fewer in-office injections.

The latest advances in the fight against many diseases involve pairing therapies with a genetic understanding of the disease process. For example, Dr. Miller explains how a trial for dry macular degeneration discovered that the treatment worked best for patients with a specific genetic subtype. “As a result of that discovery, we are now in phase three, looking to see if studying genotypes ahead of time will identify better treatment for our patients.”

Ultimately, pharmocognetic, in which a patient’s specific genotype helps dictate the best treatment regiment and may help improve vision in several complex retinal diseases.

Advances in therapies and surgical procedures have brought national interest to CEI. “We’ve been fortunate to have physicians from all over the world come and learn about some of the things we do,” says Dr. Miller. “CEI in general is involved in teaching other ophthalmologists nationally and internationally.”

In addition to hosting physicians from around the world, CEI also trains retina fellows who have two more years of training before becoming retinal surgeons. “We typically have two fellows each year, but we’re increasing the program due to growing interest – it’s a highly sought after fellowship,” says Dr. Miller.

Dr. Miller has an extensive background in basic and clinical research throughout his career and has presented his work in international clinical and scientific meetings.

Cincinnati Eye Institute’s main campus is located at 1945 CEI Drive, Cincinnati, OH 45242. For more information, call 513.984.5133 or visit www.cincinnatieye.com.